Imaging patterns of Pneumocystis jirovecii pneumonia in HIV-positive and renal transplant patients - a multicentre study.

Details

Serval ID
serval:BIB_40D99B6F770B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Imaging patterns of Pneumocystis jirovecii pneumonia in HIV-positive and renal transplant patients - a multicentre study.
Journal
Swiss medical weekly
Author(s)
Christe A., Walti L., Charimo J., Rauch A., Furrer H., Meyer A., Huynh-Do U., Heverhagen J.T., Mueller N.J., Cavassini M., Mombelli M., van Delden C., Frauenfelder T., Montet X., Beigelman-Aubry C., Arampatzis S., Ebner L.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
23/09/2019
Peer-reviewed
Oui
Volume
149
Pages
w20130
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: epublish
Abstract
To investigate differences in chest computed tomography (CT) and chest radiographs (CXRs) of Pneumocystis jirovecii pneumonia (PJP) between renal transplant recipients (RTRs) and human immunodeficiency virus (HIV)-positive patients.
From 2005 to 2012, 84 patients with PJP (RTR n = 24; HIV n = 60) were included in this retrospective multicentre study. Written informed consent was obtained. CT scans and CXRs were recorded within 2 weeks after the onset of symptoms. PJP diagnosis was confirmed either by cytology/histology or successful empirical treatment. Two blinded radiologists analysed the conventional chest films and CT images, and recorded the radiological lung parenchyma patterns, lymph node enlargement and pleural pathologies (pneumothorax, effusion). The radiological features of the two subgroups were compared.
Consolidations and solid nodules prevailed on CT in RTRs (91.7 ± 5.6% vs 58.3 ± 6.4% with HIV, p = 0.019 and 91.7 ± 5.6% vs 51.6 ± 6.5% with HIV, p = 0.005). HIV-positive patients with PJP showed more atelectasis (41.7 ± 6.4% vs 4.2 ± 4.1% in RTRs, p = 0.017) and hilar lymph node enlargement (23.3 ± 5.5% vs 0.0 ± 0.0% in RTRs, p = 0.088). Ground glass opacification was found in all cases. Pneumothorax was a rare complication, occurring in 3% of the HIV-positive patients; no pneumothorax was found in the RTRs. On CXR, the basal lungs were more affected in HIV-positive patients as compared with RTRs (p = 0.024).
PJP on CT differs substantially between RTRs and HIV-positive patients. Physicians should be aware of such differences in order not to delay treatment, particularly in renal transplant recipients.
Keywords
Adult, Aged, Female, HIV Infections, Humans, Immunocompromised Host, Kidney Transplantation, Lung/diagnostic imaging, Lymph Nodes/diagnostic imaging, Male, Middle Aged, Pneumonia, Pneumocystis/diagnostic imaging, Radiography, Registries, Retrospective Studies, Tomography, X-Ray Computed, Transplant Recipients
Pubmed
Web of science
Open Access
Yes
Create date
04/10/2019 11:22
Last modification date
26/08/2020 5:22
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